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Cardiac Asthma

Cardiac asthma is a severe and acute clinical entity caused by pulmonary venous hypertension, a consequence of acute left heart failure. Dyspnea, the cardinal symptom of the disease, needs to be differentiated from the one caused by pulmonary pathology, a difficult task in cases where the two types coexist.


Presentation

Cardiac asthma may occur in chronic cardiac patients when the underlying disease becomes decompensated, or as a manifestation of an acute cardiac condition, such as an extensive myocardial infarction that causes functional impairment of a large left ventricular mass. Such a patient will have bronchial hyper responsiveness [1] that is partially responsible for some elements of the clinical picture.

Cardiac asthma manifests as acute dyspnea and tachypnea that may progress to orthopnea and is accompanied by wheezing and dry cough. The patient may appear pale initially, but as the symptoms progress may become cyanotic. The episode may be more or less severe. The mildest form of cardiac asthma is represented by orthopnea. It is immediately relieved once the patient sits up straight in bed or on a chair for a few minutes (usually less than 10). Paroxysmal nocturnal dyspnea, the second stage in terms of severity, lasts for at least 30 minutes, even if the same position described above is assumed. It occurs during the night and symptoms wake the patient up. They consist of severe dyspnea, increased work of breathing, and gasping, causing anxiety. Acute pulmonary edema has the most dramatic presentation and the most severe origin: fulminant left ventricular failure. The patient appears very ill and experiences severe dyspnea and tachypnea. Hypoxia may cause restlessness or obnubilation, while poor peripheral perfusion may manifest as cold, sweaty extremities. The patient uses accessory respiratory muscles and experiences cough that is initially dry and subsequently becomes productive. The sputum is frothy and may contain blood.

During the acute episode, the patient may experience chest pain, usually caused by myocardial ischemia. Tachycardia diminishes the duration of the diastole and subsequently coronary filling time, also causing chest pain [2]. Palpitations can signify sinus tachycardia, atrial or ventricular arrhythmia.

Outside the acute dyspnea episode, the patient complains about other symptoms caused by chronic heart failure, such as fatigability, peripheral edema, oliguria, and nocturia.

Dyspnea
  • After symptoms have subsided, pulmonary function testing can be performed to exclude respiratory dyspnea causes.[symptoma.com]
  • Cardiac dyspnea, especially if present only with exercise, is often confused with asthma and exercise-induced bronchospasm.[ncbi.nlm.nih.gov]
  • Cardiac asthma has been used as a synonym for episodes of cough, dyspnea, and wheezing caused by left ventricular dysfunction.[ncbi.nlm.nih.gov]
  • The term cardiac asthma is much more suitable for this condition than is paroxysmal dyspnea alone, which is far less descriptive and which may include other conditions, such as Cheyne-Stokes respiration.[jama.jamanetwork.com]
Rales
  • Arrive ER and he was opened up enough that the doc could hear some fine rales in the bases.[emtlife.com]
  • In the distance hear the dry, wheezing Auscultation Wet fine basal rales, mainly in the lower lung Dry rales, mainly on the exhale. Very long exhale[medicalency.com]
  • Deep sounding rales in the chest. Baryta Mur Is indicated in old asthmatic patients with high blood, pressure. Loss of memory and mental weakness. Suffocating cough with no power to expectorate. Worse by every change of weather.[knowhomeopathy.com]
  • […] reduced, but may be normal or elevated.Often asthma goes into the initial stage of pulmonary edema, as evidenced by the blue face (especially in the nasolabial triangle), cold clammy sweat, acting on the body of the patient, the appearance of wet bubbling rale[diets-doctor.com]
  • Symptoms are characterized by the growth of its small- and medium bubbling rale, which are well heard in the anterior region of the lungs.[ladyen.netlify.com]
Cheyne-Stokes Respiration
  • The term cardiac asthma is much more suitable for this condition than is paroxysmal dyspnea alone, which is far less descriptive and which may include other conditions, such as Cheyne-Stokes respiration.[jama.jamanetwork.com]
Basilar Rales
  • Obviously with a longer transport time i would hopefully had been able to hear the fine basilar rales after the treatment, but for the future i want a stronger tool set to seperate these Corky uggg..... missed one tonight. 0130 called to male short of[emtlife.com]
Heart Failure
  • One study found that patients with cardiac asthma represented one third of congestive heart failure in elderly patients.Depending on severity, it may be classified as a medical emergency, as it can be a symptom of acute heart failure leading to the buildup[en.wikipedia.org]
  • BACKGROUND: Cardiac asthma describes symptoms of airflow obstruction due to heart failure. Chronic heart failure is associated with decreased FEV 1 , and FEV 1 improves after heart transplantation.[ncbi.nlm.nih.gov]
  • Cardiac asthma is a severe and acute clinical entity caused by pulmonary venous hypertension, a consequence of acute left heart failure.[symptoma.com]
  • From Wikidata Jump to navigation Jump to search medical diagnosis of wheezing, coughing or shortness of breath due to congestive heart failure edit English Cardiac asthma medical diagnosis of wheezing, coughing or shortness of breath due to congestive[wikidata.org]
  • failure: the Task Force on Acute Heart Failure of the European Society of Cardiology.[dx.doi.org]
Hepatojugular Reflux
  • The Kussmaul sign (paradoxical rise in jugular venous pressure on inspiration) and hepatojugular reflux are present and the diastolic blood pressure may be slightly increased. The liver may be enlarged and painful.[symptoma.com]

Workup

Clinical examination of a cardiac asthma patient reveals an anxious, diaphoretic, pale or cyanotic individual, with labored breathing, tachycardia or gallop rhythm, cold extremities and elevated jugular venous pressure. Chronic heart patients may also have pleural effusion, making lung auscultation more difficult. When feasible, auscultation reveals the presence of basal crepitations. Wheezing can be heard in acute pulmonary edema cases. The Kussmaul sign (paradoxical rise in jugular venous pressure on inspiration) and hepatojugular reflux are present and the diastolic blood pressure may be slightly increased. The liver may be enlarged and painful.

Pulmonary and cardiac dyspnea can be rapidly differentiated by measuring the brain natriuretic peptide, which rises in heart failure patients [3]. After symptoms have subsided, pulmonary function testing can be performed to exclude respiratory dyspnea causes [4].

The electrocardiogram is often abnormal in heart failure patients, showing signs of acute or chronic myocardial ischemia, acute tachyarrhythmia or bradyarrhythmia or at least left atrial enlargement [5]. Systolic and diastolic functions are best evaluated by echocardiography, which is important because reduction of either of these parameters can be associated with cardiac dyspnea. This method also identifies the cause of the heart failure, such as valvular diseases or ischemia [6] [7]. Transesophageal echocardiography, if tolerated, is especially useful because it allows direct measurement of pulmonary capillary wedge pressures [8]. Genetic testing is indicated in cases of hypertrophic and dilated cardiomyopathy [9], arrhythmogenic right ventricular cardiomyopathy and left ventricular noncompaction.

Treatment

  • The treatment for Cardiac Asthma includes a combined approach using bronchodilators, supplementary oxygen, and also the treatment of the heart failure.[epainassist.com]
  • Swollen ankles TREATMENTS FOR CARDIAC ASTHMA: Right diagnosis should be given to the patient with cardiac asthma. Treatment is given to improve the blood pumping of heart with medicines.[breath.ygoy.com]
  • Proper diagnosis is essential to the successful treatment of cardiac asthma. Treatment for individuals with cardiac asthma centers on improving heart function.[wisegeek.com]
  • Asthma Attacks and Asthma Prevention With Naturist Treatment Asthma attack: Causes, Symptoms, Signs, Treatment and Home Remedies for Asthma Allergy Induced Asthma Symptoms, Causes, Treatment and Prevent Cough Variant Asthma Treatment, Causes, Symptoms[tipdisease.com]
  • David Sedaghat, refreshments served, register Add an event Correct this listing More events at this venue Apr 3 Emergency Treatment of Asthma North Shore LIJ-Southside Hospital , Bay Shore , NY May 1 Asthma Support Lecture Series: Allergy and Asthma Connection[newsday.com]

Prognosis

  • Both groups had a similar prognosis (Fig. 1 ). Indeed, one could assume that cardiac asthma had a better prognosis because auscultation revealed fewer crackles, which could suggest less alveolar edema [ 23 ].[dx.doi.org]
  • Prognosis of Cardiac Asthma As in asthma triggered by an allergen, in cardiac asthma ensure that you don’t use an inhaler as it may worsen your condition.[onlymyhealth.com]

Etiology

  • In a study pays special attention to signs of underlying pathology that will help determine the etiology of dyspnea.[ladyen.netlify.com]
  • However, the etiology of cardiac asthma is different from true asthma that occurs due to inflammation and narrowing of air passages. In cardiac asthma the problem is related with heart.[tandurust.com]
  • Paschke spent 4 years as a Heisenberg Professor in a molecular laboratory in the Institute of Interdisciplinary Research at the Universite Libre in Brussels, Belgium working on the molecular etiology of hot thyroid nodules and the mechanism of activation[departmentofmedicine.com]
  • View Article PubMed Google Scholar Ray P, Birolleau S, Lefort Y, Becquemin MH, Beigelman C, Isnard R, Teixeira A, Arthaud M, Riou B, Boddaert J: Acute respiratory failure in the elderly: etiology, emergency diagnosis and prognosis.[dx.doi.org]

Epidemiology

  • Methods Study design and setting This epidemiological study of ARF in elderly patients was a single-center prospective study performed from February 2001 to September 2002.[dx.doi.org]
  • This work was an ancillary analysis of an epidemiological study of acute respiratory failure in elderly patients (EPIDASA study) which has been previously described in detail elsewhere [ 5 ].[dx.doi.org]
Sex distribution
Age distribution

Pathophysiology

  • Cardiac asthma produces the same symptoms, but the pathophysiology producing these symptoms is not well described.[ncbi.nlm.nih.gov]
  • The pathophysiology of the two is different with BA having an immune mediated airway narrowing, and CA having a transudative pulmonary oedema.[differencebetween.com]
  • The cardiopulmonary interaction forms the basis for the pathophysiology of cardiac asthma —a state in which disease or failure of the former manifests in pathologic findings and symptoms of the latter, the majority of which are reversible with correction[journals.lww.com]
  • To the Editor: The role of bronchial hyperresponsiveness in the pathophysiology of dyspnea in congestive heart failure has been a subject of considerable interest 1 3.[dx.doi.org]

Prevention

  • Asthma Prevention: Prevent for Asthma Attacks and Asthma Prevention With Naturist Treatment Skin Asthma: Causes, Signs, Symptoms,Prevent, Treatment and Home Remedies Seasonal Asthma Symptoms, Causes, Treatment and Prevent Asthma Prevention: Prevent for[tipdisease.com]
  • Its use can prevent heart attacks and heal its after effects. Dead cells have no substitute, but it is possible to prevent another attack, because the adjacent cells are damaged by the increased load and lack of energy.[mumio7.com]
  • Corticosteroids are used as they are known to constrict blood vessels and prevent release of cytokines. They are used only when the patient does not respond to other medications.[tandurust.com]
  • It is essential that Cardiac Asthma be treated at the right time to prevent any complications but before than that it is extremely vital to diagnose the condition as the symptoms presented by Cardiac Asthma are quite similar to other unrelated medical[epainassist.com]
  • Articles based on Health interests Healthy Eating Everyday Fitness Oral hygiene Weight Loss Sexual Well-being Hair care Diabetes Skin Care Pregnancy Healthy Skin Acne Hair loss Back Pain Stress management Weight gain Cancer Prevention Healthy Digestion[practo.com]

References

Article

  1. Chua TP, Lalloo UG, Worsdell MY, Kharitonov S, Chung KF, Coats AJ. Airway and cough responsiveness and exhaled nitric oxide in non-smoking patients with stable chronic heart failure. Heart.1996; 76(2):144–149.
  2. Peacock WF, Fonarow GC, Ander DS, et al. Society of Chest Pain Centers Recommendations for the evaluation and management of the observation stay acute heart failure patient: a report from the Society of Chest Pain Centers Acute Heart Failure Committee. Crit Pathw Cardiol. 2008;7(2):83-86.
  3. Morrison JF, Pearson SB, Dean HG. Parasympathetic nervous system in nocturnal asthma. Br. Med. J. (Clin. Res. Ed.) 1998;296(6634):1427–1429.
  4. Dickstein K, Cohen-Solal A, Filippatos G, et al, for the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur Heart J. 2008;29(19):2388-2442.
  5. Lindenfeld J, Albert NM, Boehmer JP, et al, for the Heart Failure Society of America. Executive summary: HFSA 2010 comprehensive heart failure practice guideline. J Card Fail. 2010;16(6):e1-194.
  6. Prior D, Coller J. Echocardiography in heart failure - a guide for general practice. Aust Fam Physician. 2010;39(12):904-909.
  7. Abraham J, Abraham TP. The role of echocardiography in hemodynamic assessment in heart failure. Heart Fail Clin. 2009;5(2):191-208.
  8. Meersch M, Schmidt C, Zarbock A. Echophysiology: the transesophageal echo probe as a noninvasive Swan-Ganz catheter. Curr Opin Anaesthesiol. 2016;29 (1):36-45.
  9. Grunig E, Tasman JA, Kucherer H, Franz W, Kubler W, Katus HA. Frequency and phenotypes of familial dilated cardiomyopathy. J Am Coll Cardiol. 1998;31(1):186-194.

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Last updated: 2019-07-11 22:03